Use of contingent electric skin shock in the treatment of severe problem behavior has been criticized on the grounds that (a) it is not necessary because function-based procedures using positive reinforcement are just as effective; (b) it violates contemporary ethical standards; and (c) it lacks social validity. There are good reasons to challenge these claims. The meaning of “severe problem behavior” is imprecise and we should be cautious in our claims about how to treat it. It is not clear that reinforcement-only procedures are sufficient because they are commonly paired with psychotropic medication, and there is evidence that some instances of severe behavior may be refractory to reinforcement-only procedures. Ethical standards, as expressed by the Behavior Analysis Certification Board and the Association for Behavior Analysis International, do not prohibit punishment procedures. Social validity is a complex concept that can be understood and measured in multiple, potentially conflicting ways. Because we still have a lot to learn about these matters, we should be more skeptical of sweeping claims such as the three enumerated above.

在治疗严重问题行为时使用偶然性皮肤电击受到了批评，理由是：（a）没有必要，因为使用正强化的基于功能的程序同样有效；(b) 违反当代道德标准；(c) 缺乏社会有效性。有充分的理由质疑这些说法。“严重问题行为”的含义并不精确，我们在如何对待它的说法中应该谨慎。目前尚不清楚仅强化程序是否足够，因为它们通常与精神药物搭配使用，并且有证据表明某些严重行为的情况可能对仅强化程序无效。正如行为分析认证委员会和国际行为分析协会所表达的道德标准，并不禁止惩罚程序。社会效度是一个复杂的概念，可以通过多种可能相互冲突的方式来理解和衡量。因为关于这些问题我们还有很多东西需要了解，所以我们应该对诸如上面列举的三种说法之类的笼统说法持更加怀疑的态度。